Amazingly, the actual mechanism of the migraine is still not fully understood; however, I gleaned a very useful nugget of information, and it relates to serotonin.
Other well known causes of headaches and migraines include muscle spasm, particularly in the neck; stress is a big reason; fluctuating oestrogen levels both during the menstrual cycle and during menopause – even constipation can poison the system, leading to headaches. I knew that serotonin levels were implicated in migraine, but I was surprised to learn that when the migraine sufferer vomits from the pain and nausea, this triggers a release of serotonin from the gut, and brings about immediate relief. It has been found that steady levels of serotonin in the brain prevent migraine, and that the monoamine oxidase family of enzymes break down serotonin, which is why anti depressant medications (monoamine oxidase inhibitors [MAOI]) help to prevent migraine(1). Without the serotonin, the blood vessels dilate, leading to pain and migraine.
St John’s wort is not an MAOI, but it does inhibit the uptake of serotonin in the brain, helping to keep the levels stable.
In treating migraines and headaches, the medical herbalist will always try to elicit and work with the underlying cause, and in this way use herbs to match those root problems. There are endless reasons why someone may suffer from migraines – even food intolerances may be implicated – and thus the investigation has to be as thorough as possible. As I have said a thousand times, herbs are absolutely wonderful. They can steady serotonin and stabilise the mood, calm anxiety and support those with depression, balance oestrogen levels, relax taut muscles, and clear colon congestion.
(1)^ Aggarwal M, Puri V, Puri S. Serotonin and CGRP in migraine. Ann Neurosci. 2012 Apr;19(2):88-94. doi: 10.5214/ans.0972.7531.12190210. PMID: 25205974; PMC4117050.